Galling hypocrisy from Republicans
For the past seven years, one of the major Republican attacks on the Affordable Care Act was about the process by which it was passed. Opponents argued that the law was “rammed through” Congress on a purely partisan basis. Indeed, anger about this law was focused as much on the means of it getting through as it was on the details of the law itself. I should know; I’ve been on the receiving end of just about as much criticism of the Affordable Care Act as anyone.
The passage of the Republican alternative to the ACA Thursday illustrates what a hollow and callous argument this was all along.
Let’s start with substance. As far as we know based on independent projections, the American Health Care Act would cause 24 million Americans to lose health insurance. It would massively raise premiums for the old, poor and sick (a poor 60-year-old would see insurance premiums rise by 750%). And, thanks to the most recent amendments, it would allow states to remove the most popular provisions of the ACA, which ban insurance discrimination against our sickest citizens.
The only winners from this law would be the very richest Americans, who would see a tax cut — 60% of which goes to those with incomes over $1 million. This is the most explicit redistribution from poor to rich we have ever seen in one bill.
Not only is this bill worse in every way on substance; it is worse in every way on process.
Development of the ACA began the day that Barack Obama was elected President and continued steadily through its passage 17 months later. This Republican alternative was crafted in less than three months.
The ACA was the subject of dozens of congressional hearings, with hundreds of witnesses from both sides of the aisle. The AHCA was the subject of just a couple of purely partisan committee meetings.
The basis for the ACA was a Republican plan developed by Gov. Mitt Romney that had already shown enormous success in Massachusetts. The law itself was written under the supervision of a bipartisan set of six expert senators — three from each party — and had bipartisan support until a set of town halls in the summer of 2009 altered Republican views on the law.
At one point, President Obama went to Blair House and engaged in an exhaustive seven-hour back-and-forth on the details of the legislation with Republicans and Democrats alike.
In stark contrast, those developing the AHCA have made no effort to include Democrats in the process in any way.
Even more galling is the fact that upon becoming speaker of the House, Paul Ryan pledged that “The committees should retake the lead in drafting all major legislation” — yet there has not been a single committee hearing on the new bill.
Perhaps most significantly, opponents of the ACA always argued that the effects of the law were not well understood before Congress had to vote on it.
This was clearly false. Not only were there dozens of hearings and the Massachusetts example, but the nonpartisan Congressional Budget Office supplied multiple “scores” that clearly illustrated the effects that the law would have. Over time, the CBO numbers have proved to accurately project trends in insurance premiums and coverage.
In contrast, the Republican House Thursday voted on a bill that has not even been scored by the CBO. What numbers we do have about costs and lost coverage were based on the first version of the bill. There have been dozens of changes since, most of which seem likely to worsen its design.
But we don’t know their effects — because Republicans didn’t even wait for a CBO score before bringing the new measure to a vote! They literally forced a vote on a bill before there was any clear estimate of the effect it will have on our citizens.
The hypocrisy here is astounding. The ACA was a model of carefully considering all views in crafting a law that balanced the interests of many parties in improving the U.S. health care system.
This Republican alternative is a rushed attempt at a narrowly partisan reform that will make things worse for millions of Americans. And those in the House who have voted to make it law were unacceptably, willfully ignorant of its effects. The AHCA is a failure not only in substance, but also in process.